There has been quite a bit in the news lately about women's cancers, so I thought I would chip in some thoughts.
Firstly, breast cancer. This month's Breast Cancer Awareness Month has coincided with the announcement that women's life expectancy from diagnosis with breast cancer has risen dramatically.
Of course this is good news. It may not be as good news as the headlines suggest, though. Some of the statistical rise comes from the fact that many cases are diagnosed earlier. So even if a woman dies at the same time, her "life expectancy from diagnosis" would be recorded as longer.
But amid the celebrations, the government still has an appalling policy that younger women will not be routinely screened (despite the fact that breast cancer in younger women is usually more aggressive), and women with breast cancer are having to fight for access to 'wonder drug' Herceptin.
Why? Money. The much-lauded increase in NHS spending seems to be able to find its way into the coffers of private companies, but less so into the treatment of patients.
Secondly, cervical cancer - and the recent announcement of a highly effective vaccine. Apparently, it vaccinates against the particular virus (HPV) that is transmitted by sexual contact. Which means that it needs to be administered to girls (and boys) before they become sexually active. Which, of course, has sent the Moral(ist) Minority into a frenzy of objections.
What's the thinking here? That teenage sex is so immoral that girls who do it should be punished by death by cancer?!? As Katha Pollitt asks, "What is it with these right-wing Christians? Faced with a choice between sex and death, they choose death every time. No sex ed or contraception for teens, no sex for the unwed, no condoms for gays, no abortion for anyone".
The right-wing campaigners would probably argue that providing the vaccine will "encourage" teenagers to have sex. I never thought of a vaccination as a particularly erotic thing, and there is plenty of other stuff eg. hormones, that encourage youngsters to have sex. What teenagers definitely need is help and support in having safer sex.
There has long been a problem with sexual moralism inhibiting the fight against cervical cancer. A couple of anecdotes about young women I used to know:
- S. had an abnormal smear test result. She was distraught, thought it was her fault for smoking and having sex. She would normally turn to her mum about any health or personal problem, but felt she could not in this case. (Follow-up tests were clear.)
- L. asked her GP whether it was true that girls who smoke are more likely to get cervical cancer. His reply? "It's not so much girls who smoke as the sort of girls who smoke"!
Medical knowledge of the causes of cancer is limited (perhaps because much of the research is left to charities and profit-motivated pharmaceutical companies). One upshot of this is that any kind of link gets an emphasis above its proportion.
Cervical cancer may be linked to early/promiscuous sex and to smoking, but this link can be exaggerated to an extent that blames and distresses women and unbalances the campaign against this disease. And even where the link does exist, anti-sex crusading is going to hinder, not help, women's health.
Im glad to see concern is being taken against allowing moralistic judgement attitudes to intimidate women and girls into the closet over fear of having some scarlet letter painted over their head whether if they have more traditional views on sex or not' Also were you speaking out against the stereotype that women/girls who smoke have what is commonly refered to as looser morals as well? I think thats good if you are'Maybe dangerous behavior like smoking cigarettes is an example of a behavior that is more likely to be done by young women who take more risk apart from just the smoking itself'sexual risk or whatever the case may be'But I seriously doubt every single one of the young women who smoke cigarettes do take any of the sexual or other risk' but one thing that gets me is how it appears some are taking a more likely kind of thing and turning it into an always is the case sort of thing'Id hate to hear about one of the women friends/family who smoke that Im close to or any woman have a remark like what that Surgeon implied about the character of young women who smoke' made to them based on the fact that they smoke' And on to something totally different yes I also agree that the women who do take lots of sexual risk are every bit as deserving of being treated with respect and profesionalism as those who dont' Looks like what what L experienced was a case of the doctor first stereotyping all young women smokers as loose and then also going on to express judgment moralism against any woman who is unusually sexually active'Both of those conclusions he drew are unprofessional in my book.
Thanks for that comment, Jay. I agree with what you say, which is very much in line with my feelings as outlined in the blog entry.
The thing about women smoking has just reminded me of an exchange I had with our then MP, Brian Sedgemore, in the letters pages of the Hackney Gazette some ten years ago. In his regular Gazette column, Sedgemore wrote of the dangers of smoking, and commented that "There is nothing less attractive than seeing a woman smoking in public". So I wrote in reply, berating his sexism and moralism, concluding that "There are many compelling reasons for women to give up smoking. Becoming more attractive to Brian Sedgemore is not one of them."
Hi again Janine'Another one I saw that makes what I think are irresponsible exagerated links between smoking and sexual behavior is on ProCor.org' heres part of the article in case you havent seen it.
As with the case of lung cancer, exposure to passive smoking is an independent risk factor for cervical malignancy. In a population-based case-control study in Utah, the risk estimate for exposure to environmental smoke for more than 3 hours a day was 2.96 (95% CI: 1.25 to 7.03, P=0.0028 for linear trend). This relation held after adjusting for age, years of education, church attendance, number of sexual partners, and pack years of smoking.(15) Exposure to environmental smoke at home was a far greater risk factor as compared to passive smoking away from home. The problem with cervical cancer is confounded by the inability of epidemiologists to exclude behavioral differences between smokers and nonsmokers with respect to the operation of other risk factors. A relevant example is the accuracy of reported sexual activity. Cervical cancer is believed to be due to an infectious agent transmitted sexually. Women who smoke are sexually more active.
The extraordinary sensitivity of the cervix to tobacco may relate to the finding of high levels of nicotine and conitine in the cervical mucus of smokers.(16) Perhaps carcinogenic constituents of cigarette smoke also concentrate in the cervix and play a direct mutagenic role in the etiology of the malignancy. The risk is increased when smoking is started early in life when the uterine cervix is undergoing metaplastic changes of puberty and may be particularly sensitive to carcinogenic insults.
Id like to make few observations about the article'For one I might be a little picky about this but notice how the author just say's women who smoke are more sexually active period. No as a group or generally speaking they are'I assume they are making a generally speaking or more likely to be statement but I would hope people doing research on stuff like this would be proffesional enough to point to the studies or give percentages of smokers vs non's if they are going to make a statement like that instead of just saying it's so but not giving any statistics on it'
Second notice how it said research on Cervical Cancer is confounded because they cant eliminate behavioral differences between smokers and non-smokers?And one of the reasons for that is because of accuracy of reported sexual activity? Well I have to wonder exactly what it is they are saying'Is the Idea they are trying to get across that if a woman smokes she cant be trusted to be honest with her doctor about sexual activity?In other words it also seems they may be calling women who smoke to be largely liars also'
I also wish people who write articles like that could be more detailed and give figures instead of just throwing something out and leaving many of us to make it anybodies guess as to exactly how their study was done and what percentage of who did what'
And as for Brian Sedgemore somehow I have a feeling that men smoking would be no big deal for him'Yes if a woman chooses to stop smoking Brian Sedgemore and his crowds reasons and whoever wrote that article on ProCor certainly I hope dont come into the equation. :(